Emergency First Aid UK: What to Do Before the Ambulance Arrives

When someone is bleeding badly, when breathing stops, when a child falls and doesn't get up — those minutes before an ambulance arrives are not a waiting room. They are the window where what you do actually matters. In the UK, average ambulance response times run 8 to 11 minutes in urban areas. In rural regions, during severe weather, or during major incidents with multiple casualties, that number can jump to 30 minutes or more. The British Red Cross estimates that over 140,000 lives could be saved every year in the UK if first aid was more widely known.

This guide covers the five skills that make the biggest difference in the gap between injury and professional help arriving, what belongs in a genuine emergency first aid kit (and what doesn't), UK-specific emergency scenarios, and what you should absolutely not do when someone is seriously injured.

Why First Aid Matters Before the Ambulance Arrives

The UK's emergency services are stretched. The NHS Ambulance Service faced its busiest year on record in 2024, with response times for life-threatening calls varying significantly by region. During Storm Arwen in December 2021, some communities in north-east England and Scotland waited over four hours for emergency response. When the M5 flooding hit Somerset in early 2024, road closures added significant time to ambulance arrivals across the region.

During those delays, the responsibility for keeping someone alive falls on whoever is present. Cardiac arrest, severe bleeding, choking, and strokes are time-critical: each minute without intervention reduces the chance of survival or full recovery. The UK Resuscitation Council states that for every minute without CPR, survival chances fall by approximately 7 to 10 percent. Immediate bleeding control prevents shock from developing. The FAST acronym for stroke means treatment can begin before even reaching hospital.

You do not need to be trained to do these things. You need to know the sequence, stay calm, and act. This guide covers the five interventions that save the most lives in the most common UK emergency scenarios.

The 5 Critical Skills That Save Lives

1. Hands-Only CPR

If an adult collapses and is not breathing normally — not just groaning or making noise, but not breathing in a regular, clear way — call 999 immediately and start CPR. Do not check for a pulse unless you are trained. Push hard and fast in the centre of the chest: 5 to 6 centimetres deep, at a rate of 100 to 120 compressions per minute. That is roughly the tempo of Stayin' Alive by the Bee Gees. Compress, release, compress, release. Do not stop until the ambulance crew tells you to stop.

The British Heart Foundation and NHS both recommend hands-only CPR for untrained bystanders. Chest compressions alone are sufficient to keep blood circulating. Rescue breaths are no longer recommended for untrained rescuers — the risk of doing them incorrectly and stopping compressions outweighs the benefit.

If a defibrillator (AED) is nearby, someone should fetch it while you continue compressions. AEDs are designed for untrained use: the device speaks instructions, analyses heart rhythm automatically, and will not shock someone who does not need it. There are over 30,000 public-access defibrillators in the UK, and their locations are mapped on the defibrillator locator app and websites.

For cardiac arrest in children, standard CPR with rescue breaths is recommended if you know how. If you do not, call 999 and follow the call handler's instructions.

2. Controlling Severe Bleeding

Bleeding that flows spurting or pooling on the floor is life-threatening. The priority is to stop it, and to stop it fast. Apply direct pressure to the wound using whatever is available — a clean cloth, a towel, clothing. Press hard and maintain pressure for at least 10 minutes without lifting to check. Blood clotting takes time; interrupting pressure disrupts the clot.

If direct pressure alone is not controlling the bleeding and you have a tourniquet available — a first aid tourniquet or a sturdy strap — apply it 5 to 7 centimetres above the wound (not on a joint). Once applied, do not remove it. Note the time of application. Tourniquets are widely available in UK outdoor and first aid supply retailers. British Army first aid guidance and NHS ambulance protocols both support tourniquet use as a life-saving measure for life-threatening limb bleeding.

For embedded objects (glass, metal, knives), do not remove them. Apply pressure around the object. Removing it can increase bleeding dramatically. Stabilise the object and keep the person still.

3. The Recovery Position

If someone is unconscious — not responding to you — but breathing normally, do not move them unless they are in further danger. Roll them onto their side into the recovery position: the arm nearest you bent at the elbow, the far leg bent with the knee on the floor, then roll them toward you onto their side. Tilt the head back so the airway stays open. This prevents them from choking on vomit or their tongue.

Call 999. Stay with them. Monitor their breathing continuously. If breathing stops at any point, immediately start CPR. The recovery position buys time. It does not replace professional care.

4. Recognising Stroke and Heart Attack

Stroke kills and disables fast. The FAST test is the quick assessment tool — Face (has their face dropped on one side?), Arms (can they lift both arms and hold them there?), Speech (is their speech slurred or strange?), Time (if any of these are present, call 999 immediately). Every minute of delay in treatment for ischaemic stroke means more brain cells dying. Paramedics and A&E departments are optimised to treat strokes quickly — calling 999 gets you that pathway.

Heart attack symptoms are often less dramatic than people expect. Classic signs: chest pain or pressure (like a heavy weight on the chest), pain spreading to the left arm, neck, or jaw, shortness of breath, cold sweat, nausea. Women, elderly people, and diabetics are more likely to present with atypical symptoms (unusual fatigue, back pain, abdominal discomfort). If you suspect a heart attack, call 999 immediately. Sit the person down, make them comfortable, and give them 300mg aspirin if they are not allergic and it is not contraindicated. Do not let them walk around or exert themselves.

5. Burns and Scalds

UK kitchen burns are common. Electrical burns from faulty appliances and power cuts are a risk during emergencies. Flood and storm injuries bring additional burn risks from fires, hot water, and electrical incidents.

Cool the burn with running cool (not cold) water for at least 20 minutes. This is the single most effective intervention for minor to moderate burns. Do not use ice, butter, toothpaste, or any home remedy. Remove jewellery and loose clothing from the burned area before swelling begins. Cover with a clean non-fluffy dressing (cling film is acceptable as a temporary covering, applied loosely). Do not burst blisters.

For chemical burns, flood with water for at least 20 minutes. For electrical burns, do not touch the person until you are sure the power source is disconnected. Call 999 for all but the most minor burns. For burns larger than the victim's palm, on the face, hands, feet, or joints, call 999 immediately.

Building an Emergency First Aid Kit

A standard household first aid kit from a pharmacy is fine for minor cuts and headaches. An emergency first aid kit for genuine crisis scenarios needs more: trauma-level supplies that can manage serious injuries while waiting for professional help.

Store your emergency first aid kit somewhere accessible — not locked in a cupboard with the key somewhere unknown. In a power cut, when visibility is poor and adrenaline is high, you need to reach it in under 30 seconds. A clearly labelled, high-visibility container near your emergency supplies works best.

UK Emergency Scenarios and First Aid

Power Outage Injuries

Candles left unattended during power cuts cause fires. Falls in unlit homes are common as people navigate unfamiliar routes in darkness. Generators, if used indoors or in poorly ventilated spaces, produce lethal concentrations of carbon monoxide — a risk that is invisible without a detector.

If someone has been exposed to carbon monoxide (symptoms: headache, dizziness, confusion, vomiting, loss of consciousness), get them outside immediately into fresh air. Call 999. Do not go back into the space yourself without breathing apparatus. If the person is unconscious, place them in the recovery position if breathing and start CPR if not. Carbon monoxide poisoning is the cause of several deaths in the UK each year during power cuts and severe weather events.

For cuts from trips and falls in darkness: clean with antiseptic wipes, apply pressure to stop bleeding, cover with a sterile dressing. Torches should be part of every grab bag for exactly this reason — examining an injury properly requires light.

Flood-Related Injuries

Floodwater is contaminated with sewage, chemicals, and debris. Wounds exposed to floodwater need urgent cleaning and medical attention: tetanus risk is real, and infection from contaminated water can develop rapidly. Remove any debris from wounds, clean thoroughly with clean water if available, apply a pressure dressing, and seek medical attention within 24 hours even if the wound appears minor.

Cold water immersion during floods causes hypothermia rapidly — UK floodwater is typically below 10°C even in summer. Get wet victims into dry clothing and a thermal blanket immediately. Even mild hypothermia impairs decision-making, which compounds the danger of a flood emergency.

Electrical hazards: never enter floodwater if there is any possibility of fallen power lines or submerged electrical equipment. Electricity conducts through water. If you see downed cables or suspect submerged electrical hazards, call 999 and stay clear.

Storm and Fallen Tree Injuries

Storms bring debris — roof tiles, branches, broken glass. Wound management in these scenarios is the same as standard: direct pressure, clean, dress. Broken glass embedded in tissue requires professional removal — apply pressure around the wound, stabilise the embedded fragment, and call 999.

Fallen trees present crush injury risk. If someone is trapped under a fallen tree or beam, do not attempt to move it without specialist equipment — the leverage and weight involved can cause secondary injuries that were not present initially. Call 999 and wait for emergency services. Keep the person calm, treat for shock, and monitor their breathing continuously.

When NOT to Move Someone

This is one of the most important skills in first aid, and one of the most commonly violated. Moving someone with a suspected spinal injury can cause permanent paralysis. Moving someone with a head injury incorrectly can worsen brain damage. The default instruction is: do not move someone who has a serious injury unless they are in immediate additional danger (fire, collapse, traffic).

Specific situations where you should not move someone:

• Suspected spinal injury: falls from height, diving accidents, road traffic collisions, any fall where the person reports neck or back pain or numbness
• Head injury with altered consciousness: confusion, drowsiness, vomiting, speech change, unequal pupils
• Pelvic or hip fractures: moving someone with a fractured pelvis can cause severe internal bleeding
• Chest injuries with difficulty breathing: moving them may worsen the injury

When to call 999 vs drive to A&E: call 999 for unconsciousness, suspected heart attack or stroke, severe bleeding, suspected fractures, head injuries with any symptoms, burns larger than a hand, any situation where moving the person might cause additional harm, and when you are unsure. If someone has a minor cut that is controlled by pressure, minor burns under the size of a palm, minor sprains, and you are certain there is no spinal risk and no need for immediate hospital treatment, you can drive them to A&E yourself. For anything serious, call 999 — the ambulance crew is trained to stabilise and transport correctly.

Children and Elderly: Specific Considerations

Paediatric First Aid

Children are not small adults. The priorities and techniques differ in important ways. Choking is far more common in children than adults — often caused by small objects, food, or balloons. For a choking child: give 5 back blows (heel of hand between shoulder blades), then 5 abdominal thrusts (abdominal thrusts for over 1 year, chest thrusts for infants under 1 year). Repeat until the object is cleared or they become unconscious. If they become unconscious, start CPR and call 999.

Children's skin is thinner and burns more severely for the same exposure. Burns in children should always be assessed by a medical professional — call 111 or 999 as appropriate. Febrile seizures (convulsions caused by high fever) are common in young children and terrifying to witness. Lay the child on their side, do not put anything in their mouth, do not restrain them, time the seizure, and call 999 if it lasts more than 5 minutes or they do not recover fully.

Elderly Fall Protocols

Falls are the leading cause of injury death in people over 75 in the UK. After a fall, do not rush to sit them up immediately. Check first: are they conscious? Did they hit their head? Are they complaining of pain in their neck, back, or hip? If there is any possibility of a hip fracture, spinal injury, or head injury, do not move them — call 999. Hip fractures in elderly people are frequently missed initially because the person can sometimes still walk; look for the leg rotated outward, inability to lift the heel, and pain in the hip or groin.

If they appear uninjured after a fall and want to get up, proceed slowly and in stages. First, get them to roll onto their side, then sit up slowly (wait 30 seconds at each stage to check for dizziness or pain). Do not rush this process.

Medication Management During Disruptions

If your household includes anyone on regular medication — insulin, heart medication, anti-epileptic drugs, immunosuppressants — store at least a 7-day emergency supply in your emergency kit. Hospital access during a major emergency may be disrupted. Pharmacies may be closed. A week's supply of critical medications stored separately from your normal supply could be life-saving. Check medication expiry dates quarterly and rotate your stock.

Training Resources in the UK

No guide substitutes for hands-on first aid training. The skills in this article — CPR, bleeding control, the recovery position — are learnable in a half-day course. The confidence to act under pressure is built through practice, not reading.

St John Ambulance (sja.org.uk) offers a range of first aid courses across the UK, from 3-hour emergency first aid sessions to multi-day qualifications. They also run specific courses for parents and carers of children. Community courses are often priced affordably and sometimes available free through local councils.

British Red Cross (redcross.org.uk) provides free first aid learning resources online and runs certified training courses. Their free first aid app is available on iOS and Android and includes step-by-step guides for all the emergencies covered here, accessible offline — worth downloading before an emergency makes the point moot.

NHS first aid guidance (nhs.uk/conditions/first-aid) provides basic first aid information free of charge, including video demonstrations of CPR, the recovery position, and treating choking.

If you are responsible for employees in a workplace, first aid provision is a legal requirement under the Health and Safety (First Aid) Regulations 1981. Even small businesses must have at least an appointed person for first aid.

For more on the scenarios where first aid skills are most needed in the UK, see our Power Outage guide (for candle fires and CO poisoning during power cuts), our Severe Weather guide (for storm injury management), our 72-Hour Emergency Kit guide (for kit building principles), our Family Emergency Plan guide (for household emergency planning including medical scenarios), and our Emergency Food Supply guide (for dehydration management and special dietary needs during disruptions).